Hepatitis in Africa: Uniting for the change we need

  Hepatitis B and C are two variations of a communicable disease that, at least in my experience, are rarely discussed in our offices, homes, schools, or any other day-to-day environment. Every new hepatitis infection affects normal people going about their everyday lives. We recently saw some of these real-life accounts in a Roche Diagnostics […]

 

Hepatitis B and C are two variations of a communicable disease that, at least in my experience, are rarely discussed in our offices, homes, schools, or any other day-to-day environment.

Every new hepatitis infection affects normal people going about their everyday lives. We recently saw some of these real-life accounts in a Roche Diagnostics hepatitis video awareness campaign, featuring Mary, a retired teacher and grandmother from Nairobi, and Michael, a Pharmacy Technician from Abuja, Nigeria.

Both are living with hepatitis B. Both had the courage to talk about it and because they were diagnosed and are being treated, they live relatively normal, healthy lives. More of these open conversations are needed because, throughout Africa, in 2022, over 300,000 people died from hepatitis B and C – and most never even knew they were infected.¹ Viral hepatitis is more common than many people realise, yet it remains one of the least understood infectious diseases.

The good news is that death from hepatitis need not be inevitable. It is within our power to halt the progression of these somewhat lesser-known viruses, and that begins with discussing them.2

While hepatitis A, B and C share some overlapping symptoms, they are caused by different viruses. Mother-to-child transmission of hepatitis B is particularly common in highly endemic areas, and the virus affects a cross-section of people, regardless of their lifestyle choices – different strains can be transmitted in distinct ways.2

The only way to confirm the type of hepatitis a patient has is through a blood test, which is essential for guiding appropriate treatment.

Left undetected, hepatitis can lead to serious long-term health issues, including liver disease and cancer.2 It’s estimated that various strains of hepatitis have evolved alongside humanity for millennia. But we have reached a turning point – a fork in the road that presents us with the opportunity to part ways with hepatitis. We have the science, we have the tools, and we have examples from our own continent that prove what’s possible when we act decisively.3,4

Egypt has become the first country in the world to achieve the World Health Organization’s “Gold Tier” status on the path to eliminating hepatitis C (HCV). Through a bold, government-led hepatitis C elimination campaign dubbed “100 million Healthy Lives”, which launched in 2018, screening and treatment processes were made accessible, inexpensive and convenient for all Egyptians.

Backed by the World Bank and powered by integrated diagnostics, Egypt screened over 60 million people and treated more than four million over five years.4 Since the launch of the 100 Million Healthy Lives initiative, the country has effectively contained HCV. The lesson here is simple: scale works when the right strategic partnerships and political will are mobilised.

Nigeria has also taken significant steps forward, partnering with civil society and private sector organisations to expand hepatitis B Birth Dose Vaccination and continuing to work toward broader diagnostic coverage.5

So, if such monumental mobilisation and success are possible, why has hepatitis not been eliminated across the continent yet? The truth is, hepatitis often isn’t on the radar, even when systems and tools are already in place, and in many cases, countries already have molecular testing platforms used for HIV, TB, and COVID-19 — platforms that can also be used for hepatitis B and C testing.⁵ It’s not even about reinventing the wheel. It’s about prioritising domestic funding and partnerships that maximise what we already have.6

If we talk about hepatitis more, we can move beyond the fork on the road. We can normalise hepatitis testing, make it part of routine antenatal visits, school health programmes, blood drives and community clinics. Let’s train our healthcare workers with the latest WHO guidelines and push policy to match the urgency of the epidemic.

In every country where progress has been made — from Kenya to South Africa, from Egypt to Rwanda — the common denominator is partnership. That is a combination of public-private collaboration and local community buy-in. Case studies, such as those in Egypt, have demonstrated that testing saves lives; however, alignment and ongoing conversation are crucial to sustaining progress.

There is no reason for another child to be born with hepatitis B. No reason a student-athlete in Johannesburg or a young mother in Abidjan should miss their diagnosis until it’s too late. With timely testing, affordable treatment and coordinated leadership, we can eliminate hepatitis as a public health threat by 2030.

Let this be the decade where the silence ends. Let this be the year Africa leads. We can stop hepatitis in its tracks.

 

Dr Allan Pamba is the Executive Vice President, Diagnostics, Africa, at Roche Diagnostics